Piracetam
OTHER NAME(S): 2-(2-Oxopyrrolidin-1-yl) Acetamide, 2-Oxo-1-pyrrolidin-acetamide, 2-Oxo-1-pyrrolidine-acetamide, 2-Oxo-1-pyrrolidineacetamide, 2-Oxo-pyrrolidine-1-acetamide, Barcan, Noostan, Nootrop, Nootropil, Nootropyl, Normabraïn, Pyrrolidone Acetamide, Piracetam, Piracétam
Overview
Piracetam is a lab-made chemical. In Europe, it is a prescription drug used to improve brain function. It is not approved as a drug or supplement in the US.
Piracetam is a chemical related to gamma-aminobutyric acid (GABA). It is thought to help cells in the brain and blood vessels to function better. During aging and in some kinds of diseases, the membrane that surrounds cells starts to get stiff. Piracetam is thought to help maintain the membrane.
People commonly use piracetam for breath-holding attacks, epilepsy, dizziness, dyslexia, surgery to improve blood flow to the heart, and a movement disorder often caused by antipsychotic drugs (tardive dyskinesia). It is also used for Alzheimer disease, autism, dementia, depression, memory, schizophrenia, sickle cell disease, and many other conditions, but there is no good scientific evidence to support these uses.
Uses
Possibly Effective for
- Breath-holding attacks. Taking piracetam by mouth reduces breath-holding attacks in young children.
- Surgery to improve blood flow to the heart (CABG surgery). Taking piracetam by mouth or by IV around the time of CABG surgery helps with memory and thinking skills after surgery. IV products can only be given by a healthcare provider.
- A learning disorder marked by difficulty reading (dyslexia). Taking piracetam by mouth improves some reading skills in children with dyslexia.
- Seizure disorder (epilepsy). Taking piracetam by mouth reduces some symptoms of epilepsy in some patients who are also taking antiseizure drugs.
- A movement disorder often caused by antipsychotic drugs (tardive dyskinesia). Taking piracetam by mouth can reduce some symptoms of tardive dyskinesia.
- Dizziness (vertigo). Taking piracetam by mouth or by IV improves some symptoms of vertigo. IV products can only be given by a healthcare provider.
There is interest in using piracetam for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Side Effects
When taken by mouth: Piracetam is possibly safe when used in doses of up to 24 grams daily for up to 2 weeks or 20 grams daily for up to 18 months. It's usually well-tolerated. Side effects might include constipation, stomach upset, high blood pressure, rash, and weight gain.
Precautions
When taken by mouth: Piracetam is possibly safe when used in doses of up to 24 grams daily for up to 2 weeks or 20 grams daily for up to 18 months. It's usually well-tolerated. Side effects might include constipation, stomach upset, high blood pressure, rash, and weight gain.
Pregnancy and breast-feeding: There isn't enough reliable information to know if piracetam is safe to use when pregnant or breast feeding. Stay on the safe side and avoid use.
Children: Piracetam is possibly safe when taken by mouth appropriately in doses based on age and weight.
Cocaine use disorder: Piracetam seems to increase cocaine use in people who are addicted to cocaine and are trying to quit. Until more is known, do not use piracetam if you have cocaine use disorder.
Epilepsy: Stopping piracetam or decreasing the dose of piracetam might increase the number of seizures in people with epilepsy. If you have epilepsy, only use piracetam under the care of a healthcare provider.
Huntington disease: Piracetam seems to increase symptoms in people with Huntington disease. Until more is known, do not use piracetam if you have Huntington disease.
Kidney problems: Piracetam is removed from the body by the kidneys. Talk to a healthcare provider before using piracetam if you have kidney problems.
Surgery: Piracetam might slow blood clotting. This might result in too much bleeding if it is used before surgery. Stop taking piracetam at least 2 weeks before surgery.
Interactions
Moderate Interaction
Be cautious with this combination
- Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with PiracetamPiracetam might slow blood clotting. Taking piracetam along with medications that also slow blood clotting might increase the risk of bruising and bleeding.
Dosing
Piracetam has most often been used by adults in doses of 0.8-24 grams by mouth daily for up to 18 months. In Europe, piracetam is available as a prescription drug. In the US, it is not approved for use in drugs or dietary supplements. Speak with a healthcare provider before use.
References
- May BH, Yang AW, Zhang AL, et al. Chinese herbal medicine for mild cognitive impairment and age associated memory impairment: a review of randomised controlled trials. Biogerontology 2009;10(2):109-23.
- Malykh AG, Sadaie MR. Piracetam and piracetam-like drugs: from basic science to novel clinical applications to CNS disorders. Drugs 2010;70(3):287-312.
- Waegemans T, Wilsher CR, Danniau A, et al. Clinical efficacy of piracetam in cognitive impairment: a meta-analysis. Dement Geriatr Cogn Disord 2002;13(4):217-24.
- Fang Y, Qiu Z, Hu W, et al. Effect of piracetam on the cognitive performance of patients undergoing coronary bypass surgery: A meta-analysis. Exp Ther Med 2014;7(2):429-434.
- Szalma I, Kiss A, Kardos L, et al. Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo. Ann Thorac Surg 2006;82(4):1430-5.
- Ozdemir H, Akinci E, Coskun F. Comparison of the effectiveness of intravenous piracetam and intravenous dimenhydrinate in the treatment of acute peripheral vertigo in the emergency department. Singapore Med J 2013;54(11):649-52.
- Kampman K, Majewska MD, Tourian K, et al. A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence. Addict Behav 2003;28(3):437-48.
- Libov I, Miodownik C, Bersudsky Y, et l. Efficacy of piracetam in the treatment of tardive dyskinesia in schizophrenic patients: a randomized, double-blind, placebo-controlled crossover study. J Clin Psychiatry 2007;68(7):1031-7.
- Holinski S, Claus B, Alaaraj N, et al. Cerebroprotective effect of piracetam in patients undergoing open heart surgery. Ann Thorac Cardiovasc Surg 2011;17(2):137-42.
- Lobaugh NJ, Karaskov V, Rombough V, et al. Piracetam therapy does not enhance cognitive functioning in children with down syndrome. Arch Pediatr Adolesc Med 2001;155(4):442-8.
- Koskiniemi M, Van Vleymen B, Hakamies L, et al. Piracetam relieves symptoms in progressive myoclonus epilepsy: a multicentre, randomised, double blind, crossover study comparing the efficacy and safety of three dosages of oral piracetam with placebo. J Neurol Neurosurg Psychiatry 1998;64(3):344-8.
- Fedi M, Reutens D, Dubeau F, et al. Long-term efficacy and safety of piracetam in the treatment of progressive myoclonus epilepsy. Arch Neurol 2001;58(5):781-6.
- Wilsher CR, Bennett D, Chase CH, et al. Piracetam and dyslexia: effects on reading tests. J Clin Psychopharmacol 1987;7(4):230-7.
- Di Ianni M, Wilsher CR, Blank MS, et al. The effects of piracetam in children with dyslexia. J Clin Psychopharmacol. 1985;5(5):272-8.
- Barkat K, Ahmad M, Minhas MU, et al. Development of a simple chromatographic method for the determination of piracetam in human plasma and its pharmacokinetic evaluation. Drug Res (Stuttg). 2014;64(7):384-8.
- Winblad B. Piracetam: a review of pharmacological properties and clinical uses. CNS Drug Rev. 2005;11(2):169-82.
- Winnicka K, Tomasiak M, Bielawska A. Piracetam--an old drug with novel properties? Acta Pol Pharm. 2005;62(5):405-9.
- Neznamov GG, Teleshova ES. Comparative studies of Noopept and piracetam in the treatment of patients with mild cognitive disorders in organic brain diseases of vascular and traumatic origin. Neurosci Behav Physiol. 2009;39(3):311-21.
- Moriau M, Crasborn L, Lavenne-Pardonge E, et al. Platelet anti-aggregant and rheological properties of piracetam. A pharmacodynamic study in normal subjects. Arzneimittelforschung. 1993;43(2):110-8.
- Mateo D, Giménez-Roldán S. The effect of piracetam on involuntary movements in Huntington's disease. A double-blind, placebo-controlled study. Neurologia. 1996;11(1):16-9.
- Zhang J, Wei R, Chen Z, Luo B. Piracetam for aphasia in post-stroke patients: A systematic review and meta-analysis of randomized controlled trials. CNS Drugs. 2016;30(7):575-87.
- Ricci S, Celani MG, Cantisani TA, Righetti E. Piracetam for acute ischaemic stroke. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD000419.
- Yeo SH, Lim ZI, Mao J, Yau WP. Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin Drug Investig. 2017 Jul 29.
- Rao MG, Holla B, Varambally S, et al. Piracetam treatment in patients with cognitive impairment. Gen Hosp Psychiatry. 2013;35(4):451.e5-6.
- Tuncer S, Sencan A, Aral M, Ayhan S. Piracetam-induced dysarthria: an unusual complication of antithrombotic prophylaxis after toe to finger transfer. J Reconstr Microsurg. 2011;27(9):575-6.
- El-Hazmi MA, Al-Fawaz I, Warsy A, et al. Piracetam for the treatment of sickle cell disease in children- a double blind test. Saudi Med J. 1998;19(1):22-27.
- Mikati MA, Solh HM, Deryan DE, Sahli IF, Dabbous IA. A preliminary report on piracetam in sickle cell anemia: A double-blind crossover clinical trial and effects on erythrocyte survival. The King Faisal Spec Hosp J 1983;3:233-234.
- Waters B, Resnick M, Simeon J, et al. An adverse reaction to piracetam in an hypothyroid 10 year old boy. Prog Neuropsychopharmacol. 1980;4(2):207-9.
- Dogan NÖ, Avcu N, Yaka E, et al. Comparison of the therapeutic efficacy of intravenous dimenhydrinate and intravenous piracetam in patients with vertigo: a randomised clinical trial. Emerg Med J. 2015;32(7):520-4.
- Ackerman PT, Dykman RA, Holloway C, et al. A trial of piracetam in two subgroups of students with dyslexia enrolled in summer tutoring. J Learn Disabil. 1991;24(9):542-9.
- Noorbala AA, Akhondzadeh S, Davari-Ashtiani R, Amini-Nooshabadi H. Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia. J Clin Pharm Ther. 1999;24(5):369-74.
- Grotemeyer KH, Evers S, Fischer M, Husstedt IW. Piracetam versus acetylsalicylic acid in secondary stroke prophylaxis. A double-blind, randomized, parallel group, 2 year follow-up study. J Neurol Sci. 2000;181(1-2):65-72.
- Psillas G, Pavlidis P, Karvelis I, et al. Potential efficacy of early treatment of acute acoustic trauma with steroids and piracetam after gunshot noise. Eur Arch Otorhinolaryngol. 2008;265(12):1465-9.
- Akhondzadeh S, Tajdar H, Mohammadi MR, et al. A double-blind placebo controlled trial of piracetam added to risperidone in patients with autistic disorder. Child Psychiatry Hum Dev. 2008;39(3):237-45.
- Donma MM. Clinical efficacy of piracetam in treatment of breath-holding spells. Pediatr Neurol. 1998;18(1):41-5.
- Abbaskhanian A, Ehteshami S, Sajjadi S, Rezai MS. Effects of piracetam on pediatric breath holding spells: a randomized double blind controlled trial. Iran J Child Neurol. 2012;6(4):9-15.
- Sano M, Stern Y, Marder K, Mayeux R. A controlled trial of piracetam in intellectually impaired patients with Parkinson's disease. Mov Disord. 1990;5(3):230-4.
- Tang WK, Ungvari GS, Leung HC. Effect of piracetam on ECT-induced cognitive disturbances: a randomized, placebo-controlled, double-blind study. J ECT. 2002;18(3):130-7.
- Sandyk R, Gillman MA. Piracetam causes confusion in a patient with temporal lobe epilepsy. J Am Geriatr Soc. 1985;33(4):305.
- Croisile B, Trillet M, Fondarai J, Laurent B, Mauguière F, Billardon M. Long-term and high-dose piracetam treatment of Alzheimer's disease. Neurology. 1993;43(2):301-5.
- Rosenhall U, Deberdt W, Friberg U, Kerr A, Oosterveld W. Piracetam in patients with chronic vertigo. Clin. Drug Invest. 1996;11(5):251-60.
- Rameis H, Hitzenberger G, Kutscher R, Manigley C. Pharmacokinetics of piracetam: a study on the bioavailability with special regard to renal and non-renal elimination. Int J Clin Pharmacol Ther. 1994;32(9):458-65.
- De Reuck J, Van Vleymen B. The clinical safety of high-dose piracetam--its use in the treatment of acute stroke. Pharmacopsychiatry. 1999;32 Suppl 1:33-7.
- Arhami Dolatabadi A, Larimi SR, Safaie A. Oral piracetam vs betahistine in outpatient management of peripheral vertigo; a randomized clinical trial. Arch Acad Emerg Med. 2019;7(1):e9.
- Chen SY, Liu JW, Wang YH, et al. The conditions under which piracetam is used and the factors that can improve National Institute of Health stroke scale score in ischemic stroke patients and the importance of previously unnoticed factors from a hospital-based observational study in Taiwan. J Clin Med. 2019;8(1). pii: E122.
- Hussain Y, Krishnamurthy S. Piracetam attenuates binge eating disorder related symptoms in rats. Pharmacol Biochem Behav. 2018;169:35-47.
- Dezena RMB, Antunes NJ, Campos R, et al. Pharmacodynamic evaluation of L-carnitine and piracetam in muscle injury induced by the chronic use of simvastatin. Int J Clin Pharmacol Ther 2020;58(9):482-490.
- Zongfang Z, Wenjing L, Zhaomin C, Lei Z. Therapeutic effect of piracetam with nimodipine on vascular dementia after cerebral infarction. Pak J Pharm Sci 2020;33(5(Special)):2405-2411.
- Ghazavi MR, Salehi MM, Nasiri J, Yaghini O, Mansouri V, Hoseini N. The comparison of levetiracetam and piracetam effectiveness on breath-holding spells in children: a randomized controlled clinical trial. Adv Biomed Res. 2021 Dec 25;10:47.
- Salamah A, Darwish AH. Docosahexaenoic Acid Plus Piracetam Versus Piracetam Alone for Treatment of Breath-Holding Spells in Children: A Randomized Clinical Trial. Pediatr Neurol 2023;148:32-36.
- Gouhie FA, Barbosa KO, Cruz ABR, Wellichan MM, Zampolli TM. Cognitive effects of piracetam in adults with memory impairment: A systematic review and meta-analysis. Clin Neurol Neurosurg 2024;243:108358.
